One of the seven Grand Challenges aims is to improve child access to evidence-based care by trained health providers. Three of the other Grand Challenges can also be addressed in child and adolescent mental health. These are:
(i) To integrate screening and core packages of services into routine primary health care;
(ii) To provide effective and affordable community-based care and rehabilitation;
(iii) To develop effective treatments for use by non-specialists, including lay health workers with minimal training.

The aim of this approach is to promote mental well-being and support positive cognitive development to break the vicious cycle of mental illness from continuing through adulthood and having a detrimental effect on the quality of life of the individual. Kenya has no country-specific operational model that addresses this matter at scale. The World Health Organization (WHO) has put together a multi-stakeholder model for a primary school intervention that has been successfully piloted in 24 secondary schools in Australia. The Africa Mental Health Foundation (AMHF) has piloted the same model in one rural school in Kenya. The Kenya Integrated Intervention Model for Dialogue and Screening to Promote Children’s Mental Well-being (KIDS) will bring this pilot to two administrative districts in Kenya with the potential for further scale up.

KIDS will demonstrate the feasibility of a multi-stakeholder service model that will maximize the potential of children by promoting mental well-being, preventing mental illness, and treating existing mental illness.

To train large numbers of primary health care workers to successfully identify and treat substance use disorders in their practices through high-quality, globally-available, free-to-use, and low-cost to assemble, computer-, peer-, and mentor-supported learning.

1: To promote mental well being and prevent mental illness in 5,740 primary school children (6-13 years) in 18 primary schools in two rural districts in Eastern Kenya
2: To facilitate intervention for children with mental illnesses identified from the 5,740 primary school children
3: To evaluate the efficacy of KIDS.

KIDS will conduct a randomized wait-listed control study. Given the life of KIDS, the intervention will run for 12 months in each of the districts with a 6-months overlap. The district that becomes the experimental or the waitlisted control group will be determined by balloting.
Sample size: The study will screen a total of 5,740 children
Description of instruments: The instruments were chosen on the basis of known psychometric properties, worldwide use and brevity. We have the necessary authorizations where needed.
i) The WHO mhGAP-IG for psycho education and assessment on the various symptoms of mental illnesses in children
ii) The NOK on the culture specific physical symptoms associated with mild psychiatric disorders. It was developed by among others, the PI of this project. This tool’s psychometric properties have been tested in Kenya where it was shown to have a reliability coefficient of 0.9733
iii) ASEBA (a) for screening to identify children at risk of developing mental illness (b) to assess changing means of symptoms as reported by parents and teachers.
iv) MINI KID-Version for 6-14 years to provide Diagnostic Statistical Manual Version IV/International Classification of Diseases Version 10 (DSM-IV/ICD-10) equivalent diagnoses
v) Stigma ToolKit to evaluate changing patterns of community and individual stigma to mental illnesses (S)
vi) MIMH Scale for evaluating functional outcomes. The MIMH was chosen because it is specific for measuring school related functional outcomes on mental health psycho education and interventions in school and has the following domains from the perspective of the school children concerning the school:
(a) Teacher/student relationships - six questions
(b) School performance – three questions
(c) School/parent relationship – one question
(d) School attachment – 7 questions. It has a total of 17 questions and one specific question for the different types of substance use.
vii) Resilience scale to evaluate the general wellbeing. It tests the children’s coping mechanism with adversities (that cannot be eliminated by this program in the short term).
viii) Researcher designed tools will be used to assess
(a) Social demographic characteristics of study participants,
(b)school records,
(c) Clinic records,
(d) case management records,
(e) capture instruments for any emerging issues
End Date: September 2015